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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Texas rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $93$6030%10%10th90th$191Professionalmedian $95 · 10th–90th $69$1230%20%10th90th$95$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$95.50
Typical High
$14,791.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$120.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$616.60
Christus
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$120.23
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$131.83
Typical High
$218.78
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$229.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$302.00
Providence
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$223.87
Providence
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$239.88
Typical High
$302.00
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$120.23
Typical High
$169.82